Clinic, weeks ago. A Doctor encouraging her patient to return to a life he enjoyed. (We will call him Michael). Face all lit up as the Doctor painted a beautiful alternative. It was a touching sight.
A few days later I saw Michael on the ward for a routine procedure. I sat next to him to chat some more. He loved swimming he said, wished he could return to his “first love”. Used to compete nationally as a youngster- he had the same dreamy-happy face I saw in Clinic! Why didn’t he, I asked, he doesn’t have to turn pro. Not enough hours in the day or pennies in the bank account, he replied. No, Michael sighed. He had many responsibilities, & people like him did not do things like this.
A friend & I were skype-ing earlier. Its been a pretty standard year for him so far- he has already dumped his new year’s resolutions, no healthier, & continuing his love-hate relationship with social media.
We have all been there. Over the years I had so many unfinished resolutions that I dreaded those New Year’s eve conversations with my Dad. I can still hear him now- What’s your new resolution, or What [insert your dreaded question here]. I dealt with these by stating regally that I did not believe in resolutions. By that, of course I meant “Can we talk about something else?”.
Of the many lessons from my previous career, a valuable one was how to stick to my resolutions/goals.
Having had fun discussing favourite hacks with my friend, I wondered if anyone else could use these as we close the last day of 2016’s first month?! Here goes:
My resolutions derail due to 2 broad reasons: planning, & productivity issues.
- Define & Diary– Keep it simple. What precisely do I want to achieve? Then I break it down to daily tasks needed to achieve it. Finally I allocate realistic times in my diary for those tasks.
I love conferences! The collaborative spirit, rejuvenating quality, platform to discuss state of the profession, catching up with friends, and of course sleep-deprived exhaustion. What’s not to love?! I don’t, however blog about them. Yet this year I attended some which were so inspiring that I wanted to mention a few things.
Royal College of GPs Annual Conference
Back in Year 1 Graduate Entry Medicine the concept of inflammation was drilled into us. The body’s natural response to infection or injury. You know it’s happening to you when the infected/injured area turns a little red, swells a bit, becomes warm & painful, and the area has reduced function- sore throat for example! So, I kept wondering, why do we take anti-inflammatory medications like Ibuprofen as soon as we have sore throat? Surely it’s best to let our body start the fight? Voila! Research was presented at the RCGP’s Annual Conference that answered my question. Evidence shows that Ibuprofen doesn’t help with sore throats or colds in adults, and some patients later returned with worse symptoms. Paracetamol worked better. Data did not cover children, & results for chest infections in adults were different. A nice summary here.
Posted in Collaborate To Win, Evidence-Based Medicine, Graduate Entry Medicine, Interesting Podcasts & Articles
Tagged Art of Medicine, EBM, Evidence-Based Medicine, Graduate Entry Medicine, Medical School, Medical Student, Multidisciplinary, RCGP, Sepsis, TED Talks
“Have you ever cured anyone?”
I was thumbing through medical notes with my Consultant Psychiatrist (CP) one afternoon, having seen a few too many patients who were perpetually in Mental Health Services. I felt I had no talent for it and out came the question. My CP replied in an affably egalitarian manner, asking me if I had ever seen an Endocrinologist cure diabetes. Psychiatrists, he continued, help patients manage their chronic disease & have the desired quality of life. Just like Endocrinologists. Mental health, to me is as important as the physical. But it had never occurred to me to look at depression, for example, like I would see diabetes- a chronic condition where a patient has to take precautions & treatment to prevent deterioration, and adapt their lifestyle but not sacrifice their ambitions in life! This gave me pause.
Collage put together for patients by one of our nurses!
Kindly finding time in his schedule my CP showed me a unique view of Psychiatry. Finding a patient’s unique experience of a common illness, seeing the method behind madness (no offence intended), and helping patients to understand when the organ they use to do so isn’t functioning well. He thoughtfully answered all my constant queries- why this medication, how come he trusts this patient, why is that mental illness, why is that scientific. The Psychiatry he taught me was pragmatic not a collection of wishy-washy, subjective interpretations, and he certainly did not stick people in boxes that did not fit!
You know, the vast majority of physically ill patients with their spirits intact seem to function quite well. But ‘there’s nothing like the sight of an amputated spirit; there’s no prosthetic for that‘. They look devastated even in perfect physical health. The treatments were transformative in some cases albeit time consuming! I began to see this medical specialty as intellectually challenging, extraordinarily multidisciplinary, and omnipresent. So many of us are just a crisis away from suffering from mental illness.
I walked around the ward surrounded by acutely ill patients trying to understand how on earth to practice anything! You see, medical students need to devote a lot of time practicing our newly acquired skills on real-life patients if we want to be good doctors. Yet these patients were so far gone, their minds so broken that it was impossible to make any sense of what they were saying or doing.
I had approached a patient earlier- he couldn’t concentrate on much. The next stared at the floor, completely mute; while my very presence infuriated another so much that he screamed and screamed! Knowing how much this specific patient liked to throw bodily fluids at folks, I decided to walk away. I am not cut out for Psychiatry, I thought. How do you help anyone this ill?! I sat down feeling very stupid and wondering what I am possibly meant to be learning when a nurse struck up a conversation. She listened patiently and gave me several tips.
Thus brightening up a little I walked over to a new admission to our ward- an agitated man whose mind was riddled with psychosis. We ended up having a useful chat; somehow he understood I was a student doctor trying to practise my skills. I learnt a lot on my ward that day. But perhaps the most important of all was an insight into compassion. My helpful nurse crystallised it best, “Even if their words make no sense, respond to the emotions behind the words. They may not have seen a lot of understanding.” A poignant and practical lesson to carry with me throughout my future career.
Last summer I set up a twitter account for queries on useful stuff for Graduate Entry Medicine (GEM) applications. It’s a tiny space for friends to tweet/ Direct Message their questions, & form a support network if retraining to be a medic is their thing.
@A101hacks on Twitter
I must say that the passion and determination folks show for retraining to be a doctor is nothing short of humbling! I was replying to one such direct message this weekend when something occurred to me….
…most of the questions fit into certain themes. A popular one is secrets to a successful GEM application. Now, there is no such thing as a simple application to medical school. And there is even more to consider for something as competitive as GEM! But at the heart of it all lies a very simple truth.
“The defining factor for success is never resources; it’s resourcefulness.” -Tony Robbins.
Of the many things I learnt in my previous career, this one lesson has served me incredibly well in life. GEM application was no different. Here’s Tony Robbins himself; saying it better than I can ever manage.
I was directed by my busy Consultant to take a medical history. So I walked over to this elderly gentleman to find out what had happened to bring him to hospital. He barely answered my questions, choosing instead to tell me all about his wife.
Suravi. April 2015.
I felt my impatience rising. “The Consultant will get called into something else”, I began to worry. “I need to present this case back to her! Why wouldn’t he just answer my questions?”
As my frustration started boiling over I realised I was treating my patient as “liver metastasis on Bed 3”. I had no clinical responsibilities as a medical student and thus could make the time to listen to what was actually bothering him. Turned out his wife, suffering from advanced MS was home alone. He did not care much about himself.
In all the rush to ensure I was ticking boxes to prove I am correctly completing my course I had forgotten something I thought I couldn’t possibly forget: every patient has a story. And the art of Medicine is to apply our training in that context.
My other half, John and I blog about our life as we retrain. John wants to be a teacher and I am training to be a medical doctor. So why do I need this platform? For one simple reason- the blog John and I share is what I see as our home life.There are plenty of lessons, tips, stories, and experiences (for anyone thinking of retraining after a L-O-N-G absence from education) we want to share on our home-life blog. This one is my proto-professional space.
There is, however another reason!
I run a twitter account for those who want to study Medicine on a fast-track course, like the one I am on. Over the past several months my friends on there have been encouraging me to talk about my experiences as I go through my clinical placements. There are plenty of excellent blogs doing just that: Lauren Clarke’s, for example. So struggling to think of anything else I could add I kept on tweeting. But as time wore on I realised that each one of us are on a unique journey. And believe you me, 140 characters are definitely not enough to do justice to that!
Here’s hoping you will find some value in my musings.